NSG6020 FINAL EXAM QUESTIONS AND
CORRECT VERIFIED ANSWERS
Heberden'sA2nodesA2areA2commonlyA2foundA2inA2whichA2oneA2ofA2theA2followingA2disease
s?A2-A2Ans--DegenerativeA2jointA2disease
YouA2areA2beginningA2theA2examinationA2ofA2theA2skinA2onA2aA225-year-
oldA2teacher.A2YouA2haveA2previouslyA2elicitedA2thatA2sheA2cameA2toA2theA2officeA2forA2eva
luationA2ofA2fatigue,A2weightA2gain,A2andA2hairA2loss.A2YouA2stronglyA2suspectA2thatA2sheA2
hasA2hypothyroidism.A2WhatA2isA2theA2expectedA2moistureA2andA2textureA2ofA2theA2skinA2o
fA2theA2patientA2withA2hypothyroidismA2-A2Ans--dryA2andA2rough
YouA2areA2assessingA2aA2patientA2withA2jointA2painA2andA2areA2tryingA2toA2decideA2whether
A2itA2isA2inflammatoryA2orA2noninflammatory A2inA2nature.A2WhichA2oneA2ofA2theA2followingA2
symptomsA2isA2consistentA2withA2anA2inflammatoryA2process?A2-A2Ans--tenderness
AA268-year-
oldA2retiredA2farmerA2comesA2toA2yourA2officeA2forA2evaluationA2ofA2aA2skinA2lesion.A2OnA2t
heA2rightA2temporalA2areaA2ofA2theA2forehead,A2youA2seeA2aA2flattenedA2papuleA2theA2sam
eA2colorA2asA2hisA2skin,A2coveredA2byA2aA2dryA2scaleA2thatA2isA2roundA2andA2feelsA2hard.A2
HeA2hasA2severalA2moreA2ofA2theseA2scatteredA2onA2theA2forehead,A2armsA2andA2legs.A2B
asedA2onA2thisA2description,A2whatA2isA2yourA2mostA2likelyA2diagnosis?A2-A2Ans--
actinicA2keratosis
AA228-year-
oldA2graduateA2studentA2comesA2toA2yourA2clinicA2forA2evaluationA2ofA2painA2"allA2over."A2
WithA2furtherA2questioning,A2sheA2isA2ableA2toA2relateA2thatA2theA2painA2isA2worseA2inA2theA
2neck,A2shoulders,A2hands,A2lowA2backA2andA2knees.A2SheA2deniesA2swellingA2inA2herA2joi
nts.A2SheA2statesA2thatA2theA2painA2isA2worseA2inA2theA2morning.A2ThereA2isA2noA2limitation
A2inA2herA2rangeA2ofA2motion.A2OnA2physicalA2examination,A2sheA2hasA2severalA2pointsA2o
nA2theA2musclesA2ofA2theA2neck,A2shouldersA2andA2backA2thatA2areA2tenderA2toA2palpation.
A2MuscleA2strengthA2andA2rangeA2ofA2motionA2areA2normal.A2WhichA2oneA2ofA2theA2followin
gA2isA2likelyA2theA2causeA2ofA2herA2pain?A2-A2Ans--fibromyalgia
AA2newA2patientA2isA2complainingA2ofA2severeA2pruritusA2thatA2isA2worseA2atA2night.A2Sever
alA2familyA2membersA2alsoA2haveA2theA2sameA2symptoms.A2UponA2examination,A2areasA2
ofA2excoriatedA2papulesA2areA2notedA2onA2someA2ofA2theA2interdigitalA2websA2ofA2bothA2ha
ndsA2andA2onA2theA2axillae.A2ThisA2findingA2isA2mostA2consistentA2with:A2-A2Ans--Scabies
AnA2obeseA255-year-
oldA2womanA2wentA2throughA2menarcheA2atA2ageA216A2andA2menopauseA22A2yearsA2ago.A
2SheA2isA2concernedA2becauseA2anA2auntA2hadA2severeA2osteoporosis.A2WhichA2oneA2ofA2
theA2followingA2isA2aA2riskA2factorA2forA2osteoporosis?A2-A2Ans--DelayedA2menarche
, Ms.A2WhitingA2isA2aA268-year-oldA2femaleA2whoA2comesA2inA2forA2herA2usualA2follow-
upA2visit.A2YouA2noticeA2aA2fewA2flatA2redA2andA2purpleA2lesions,A2aboutA26A2centimetersA2i
nA2diameter,A2onA2theA2ulnarA2aspectA2ofA2herA2forearmsA2butA2nowhereA2else.A2SheA2doe
sn'tA2mentionA2them.A2TheyA2areA2tenderA2whenA2youA2examineA2them.A2WhatA2shouldA2y
ouA2do?A2-A2Ans--AskA2howA2sheA2acquiredA2them.
AA258-year-
oldA2manA2comesA2toA2yourA2officeA2complainingA2ofA2bilateralA2backA2painA2thatA2nowA2a
wakensA2himA2atA2night.A2ThisA2hasA2beenA2steadilyA2increasingA2forA2theA2pastA22A2mont
hs.A2WhichA2oneA2ofA2theA2followingA2isA2theA2mostA2reassuringA2inA2thisA2patientA2withA2b
ackA2pain?A2-A2Ans--PainA2thatA2isA2bilateral
TheA2Phalen'sA2testA2isA2usedA2toA2evaluate:A2-A2Ans--
inflammationA2ofA2theA2medianA2nerve
WhichA2ofA2theA2followingA2wouldA2leadA2youA2toA2suspectA2aA2hydroceleA2versusA2otherA2
causesA2ofA2scrotalA2swelling?A2-A2Ans--AA2positiveA2transilluminationA2test
YouA2areA2examiningA2aA2newbornA2andA2noteA2thatA2theA2rightA2testicleA2isA2notA2inA2theA2
scrotum.A2WhatA2shouldA2youA2doA2next?A2-A2Ans--
AttemptA2toA2bringA2downA2theA2testisA2fromA2theA2inguinalA2canal
AA250-year-
oldA2truckA2driverA2comesA2toA2yourA2clinicA2forA2aA2workA2physical.A2HeA2hasA2hadA2noA2u
pperA2respiratory,A2cardiac,A2pulmonary,A2gastrointestinal,A2urinary,A2orA2musculoskeletal
A2systemA2complaints.A2HisA2pastA2medicalA2historyA2isA2significantA2forA2mildA2arthritisA2a
ndA2priorA2kneeA2surgeryA2inA2college.A2HeA2isA2marriedA2andA2justA2changedA2jobs,A2work
ingA2forA2aA2differentA2truckingA2company.A2HeA2smokesA2oneA2packA2ofA2cigarettesA2aA2d
ay,A2drinksA2lessA2thanA2sixA2beersA2aA2week,A2andA2deniesA2usingA2anyA2illegalA2drugs.A2
HisA2motherA2hasA2highA2bloodA2pressureA2andA2arthritisA2andA2hisA2fatherA2diedA2ofA2lung
A2cancerA2inA2hisA2sixties.A2OnA2examination,A2hisA2bloodA2pressureA2isA2130/80A2andA2his
A2pulseA2isA280.A2HisA2cardiac,A2lung,A2andA2abdominalA2examinationsA2areA2normal.A2HeA
2hasA2noA2inguinalA2hernia,A2butA2onA2hisA2digitalA2rectalA2examinationA2youA2palpateA2aA2
soft,A2smooth,A2andA2nontenderA2pedunculatedA2massA2onA2theA2posteriorA2wallA2ofA2theA2
rectum.A2WhatA2anal,A2rectal,A2orA2prostateA2disorderA2bestA2fitsA2hisA2presentation?A2-
A2Ans--RectalA2polyp
AA215-year-
oldA2highA2schoolA2footballA2playerA2isA2broughtA2toA2yourA2officeA2byA2hisA2mother.A2HeA2i
sA2complainingA2ofA2severeA2testicularA2painA2sinceA2exactlyA28:00A2thisA2morning.A2HeA2d
eniesA2anyA2sexualA2activityA2andA2statesA2thatA2heA2hurtsA2soA2badA2heA2can'tA2evenA2uri
nate.A2HeA2isA2nauseatedA2andA2isA2throwingA2up.A2HeA2deniesA2anyA2recentA2illnessA2orA2f
ever.A2HisA2pastA2medicalA2historyA2isA2unremarkable.A2HeA2deniesA2anyA2tobacco,A2alcoh
ol,A2orA2drugA2use.A2HisA2parentsA2areA2bothA2inA2goodA2health.A2OnA2examination,A2youA2
seeA2aA2youngA2teenagerA2lyingA2onA2theA2bedA2withA2anA2emesisA2basin.A2HeA2isA2veryA2u
ncomfortableA2andA2keepsA2shiftingA2hisA2position.A2HisA2bloodA2pressureA2isA2150/100,A2
CORRECT VERIFIED ANSWERS
Heberden'sA2nodesA2areA2commonlyA2foundA2inA2whichA2oneA2ofA2theA2followingA2disease
s?A2-A2Ans--DegenerativeA2jointA2disease
YouA2areA2beginningA2theA2examinationA2ofA2theA2skinA2onA2aA225-year-
oldA2teacher.A2YouA2haveA2previouslyA2elicitedA2thatA2sheA2cameA2toA2theA2officeA2forA2eva
luationA2ofA2fatigue,A2weightA2gain,A2andA2hairA2loss.A2YouA2stronglyA2suspectA2thatA2sheA2
hasA2hypothyroidism.A2WhatA2isA2theA2expectedA2moistureA2andA2textureA2ofA2theA2skinA2o
fA2theA2patientA2withA2hypothyroidismA2-A2Ans--dryA2andA2rough
YouA2areA2assessingA2aA2patientA2withA2jointA2painA2andA2areA2tryingA2toA2decideA2whether
A2itA2isA2inflammatoryA2orA2noninflammatory A2inA2nature.A2WhichA2oneA2ofA2theA2followingA2
symptomsA2isA2consistentA2withA2anA2inflammatoryA2process?A2-A2Ans--tenderness
AA268-year-
oldA2retiredA2farmerA2comesA2toA2yourA2officeA2forA2evaluationA2ofA2aA2skinA2lesion.A2OnA2t
heA2rightA2temporalA2areaA2ofA2theA2forehead,A2youA2seeA2aA2flattenedA2papuleA2theA2sam
eA2colorA2asA2hisA2skin,A2coveredA2byA2aA2dryA2scaleA2thatA2isA2roundA2andA2feelsA2hard.A2
HeA2hasA2severalA2moreA2ofA2theseA2scatteredA2onA2theA2forehead,A2armsA2andA2legs.A2B
asedA2onA2thisA2description,A2whatA2isA2yourA2mostA2likelyA2diagnosis?A2-A2Ans--
actinicA2keratosis
AA228-year-
oldA2graduateA2studentA2comesA2toA2yourA2clinicA2forA2evaluationA2ofA2painA2"allA2over."A2
WithA2furtherA2questioning,A2sheA2isA2ableA2toA2relateA2thatA2theA2painA2isA2worseA2inA2theA
2neck,A2shoulders,A2hands,A2lowA2backA2andA2knees.A2SheA2deniesA2swellingA2inA2herA2joi
nts.A2SheA2statesA2thatA2theA2painA2isA2worseA2inA2theA2morning.A2ThereA2isA2noA2limitation
A2inA2herA2rangeA2ofA2motion.A2OnA2physicalA2examination,A2sheA2hasA2severalA2pointsA2o
nA2theA2musclesA2ofA2theA2neck,A2shouldersA2andA2backA2thatA2areA2tenderA2toA2palpation.
A2MuscleA2strengthA2andA2rangeA2ofA2motionA2areA2normal.A2WhichA2oneA2ofA2theA2followin
gA2isA2likelyA2theA2causeA2ofA2herA2pain?A2-A2Ans--fibromyalgia
AA2newA2patientA2isA2complainingA2ofA2severeA2pruritusA2thatA2isA2worseA2atA2night.A2Sever
alA2familyA2membersA2alsoA2haveA2theA2sameA2symptoms.A2UponA2examination,A2areasA2
ofA2excoriatedA2papulesA2areA2notedA2onA2someA2ofA2theA2interdigitalA2websA2ofA2bothA2ha
ndsA2andA2onA2theA2axillae.A2ThisA2findingA2isA2mostA2consistentA2with:A2-A2Ans--Scabies
AnA2obeseA255-year-
oldA2womanA2wentA2throughA2menarcheA2atA2ageA216A2andA2menopauseA22A2yearsA2ago.A
2SheA2isA2concernedA2becauseA2anA2auntA2hadA2severeA2osteoporosis.A2WhichA2oneA2ofA2
theA2followingA2isA2aA2riskA2factorA2forA2osteoporosis?A2-A2Ans--DelayedA2menarche
, Ms.A2WhitingA2isA2aA268-year-oldA2femaleA2whoA2comesA2inA2forA2herA2usualA2follow-
upA2visit.A2YouA2noticeA2aA2fewA2flatA2redA2andA2purpleA2lesions,A2aboutA26A2centimetersA2i
nA2diameter,A2onA2theA2ulnarA2aspectA2ofA2herA2forearmsA2butA2nowhereA2else.A2SheA2doe
sn'tA2mentionA2them.A2TheyA2areA2tenderA2whenA2youA2examineA2them.A2WhatA2shouldA2y
ouA2do?A2-A2Ans--AskA2howA2sheA2acquiredA2them.
AA258-year-
oldA2manA2comesA2toA2yourA2officeA2complainingA2ofA2bilateralA2backA2painA2thatA2nowA2a
wakensA2himA2atA2night.A2ThisA2hasA2beenA2steadilyA2increasingA2forA2theA2pastA22A2mont
hs.A2WhichA2oneA2ofA2theA2followingA2isA2theA2mostA2reassuringA2inA2thisA2patientA2withA2b
ackA2pain?A2-A2Ans--PainA2thatA2isA2bilateral
TheA2Phalen'sA2testA2isA2usedA2toA2evaluate:A2-A2Ans--
inflammationA2ofA2theA2medianA2nerve
WhichA2ofA2theA2followingA2wouldA2leadA2youA2toA2suspectA2aA2hydroceleA2versusA2otherA2
causesA2ofA2scrotalA2swelling?A2-A2Ans--AA2positiveA2transilluminationA2test
YouA2areA2examiningA2aA2newbornA2andA2noteA2thatA2theA2rightA2testicleA2isA2notA2inA2theA2
scrotum.A2WhatA2shouldA2youA2doA2next?A2-A2Ans--
AttemptA2toA2bringA2downA2theA2testisA2fromA2theA2inguinalA2canal
AA250-year-
oldA2truckA2driverA2comesA2toA2yourA2clinicA2forA2aA2workA2physical.A2HeA2hasA2hadA2noA2u
pperA2respiratory,A2cardiac,A2pulmonary,A2gastrointestinal,A2urinary,A2orA2musculoskeletal
A2systemA2complaints.A2HisA2pastA2medicalA2historyA2isA2significantA2forA2mildA2arthritisA2a
ndA2priorA2kneeA2surgeryA2inA2college.A2HeA2isA2marriedA2andA2justA2changedA2jobs,A2work
ingA2forA2aA2differentA2truckingA2company.A2HeA2smokesA2oneA2packA2ofA2cigarettesA2aA2d
ay,A2drinksA2lessA2thanA2sixA2beersA2aA2week,A2andA2deniesA2usingA2anyA2illegalA2drugs.A2
HisA2motherA2hasA2highA2bloodA2pressureA2andA2arthritisA2andA2hisA2fatherA2diedA2ofA2lung
A2cancerA2inA2hisA2sixties.A2OnA2examination,A2hisA2bloodA2pressureA2isA2130/80A2andA2his
A2pulseA2isA280.A2HisA2cardiac,A2lung,A2andA2abdominalA2examinationsA2areA2normal.A2HeA
2hasA2noA2inguinalA2hernia,A2butA2onA2hisA2digitalA2rectalA2examinationA2youA2palpateA2aA2
soft,A2smooth,A2andA2nontenderA2pedunculatedA2massA2onA2theA2posteriorA2wallA2ofA2theA2
rectum.A2WhatA2anal,A2rectal,A2orA2prostateA2disorderA2bestA2fitsA2hisA2presentation?A2-
A2Ans--RectalA2polyp
AA215-year-
oldA2highA2schoolA2footballA2playerA2isA2broughtA2toA2yourA2officeA2byA2hisA2mother.A2HeA2i
sA2complainingA2ofA2severeA2testicularA2painA2sinceA2exactlyA28:00A2thisA2morning.A2HeA2d
eniesA2anyA2sexualA2activityA2andA2statesA2thatA2heA2hurtsA2soA2badA2heA2can'tA2evenA2uri
nate.A2HeA2isA2nauseatedA2andA2isA2throwingA2up.A2HeA2deniesA2anyA2recentA2illnessA2orA2f
ever.A2HisA2pastA2medicalA2historyA2isA2unremarkable.A2HeA2deniesA2anyA2tobacco,A2alcoh
ol,A2orA2drugA2use.A2HisA2parentsA2areA2bothA2inA2goodA2health.A2OnA2examination,A2youA2
seeA2aA2youngA2teenagerA2lyingA2onA2theA2bedA2withA2anA2emesisA2basin.A2HeA2isA2veryA2u
ncomfortableA2andA2keepsA2shiftingA2hisA2position.A2HisA2bloodA2pressureA2isA2150/100,A2